A doctor... minus the mask.

A blog of my interests. Medicine, surgery, martial arts, weight lifting, gaming, music and memes. Read my first blog for my introduction =D http://doctorphantom.tumblr.com/post/50992745395/tips-hat-greetings-im-a-newly-qualified-doctor

[doctorphantom]

"I got fat ever since I started working as a doctor....there is no time for gym!"

Preposterous!

I did think like this for the first few months I started working as a doctor but a good friend of mine told me that it's all about being responsible with YOURSELF just as you are responsible with your PATIENTS.

You wouldn't leave work knowing one of your patients needs attention, right? In the same way you shouldn't end the day without making sure you are looking after your body.

There are a ton of great sites and youtube videos out there to help you do what you want. If I could suggest one I would highly recommend scooby's workshop youtube channel. Women can use his stuff too, but with lighter weights for most. An excellent source of information with a lot of scientifically researched (words us doctors like to hear) workout tips.

Anyway, work hard, keep fit and look fabulous you gorgeous followers you! DoctorPhantom

[best-of-memes]

[doctorphantom]

haha, awesome

[doctorphantom]

10 Tips For You Newbie Doctors from Someone Who Was in Your Shoes Not Too Long Ago

Soooo black Wednesday has been and gone. For the unintiated this is the day when all the fresh doctors from medical school arrive to take up their first jobs.

(no, we'll be fine! I promise!) I am a year senior so we get inducted and start around 2 days later than the newbie doctors. When I finally met the 2 doctors under my tutelage one of them burst into tears in a mixed state of happiness at my arriving and reflection of her struggles during the last couple of days and the other was clearly stressed out of her mind and putting on a brave face.

Over the next week I gave them some advice and guidance and they started leaving on time and in fact became much more confident with their role. We even have bowling with the team to look forward to now that everyone has settled in. I hope to share the advice I gave them with anyone else who is a new doctor and finding things daunting. This is advice from someone who has been in your shoes and needed this advice at that time. Hope it helps. 1. You should never be I'm a position where you are the last port of call for medical advice - you will always have seniors to ask advice from. Please seek their advice and don't feel you are alone. We expect this of you in the first few weeks. This leads me onto...

2. If there is any doubt...ASK! - A junior that is not aware of their limited knowledge and of when they should call for advice is a dangerous doctor. If you have any doubt just run it by a senior. Do not think this makes you a worse doctor. It makes you a better one.

3. The senior nurse is a font of knowledge - you can always ask their advice on things. They have been there for years and will know the ins and outs of the wards. Want to know what the usual discharge planning for a fractured neck of femur is? Ask the sister. Want to know what clinics you can refer your patient to? Ask the sister. Want to get someone to calm down a patient's family since you are preoccupied....who you gonna call? Just hope you don't have a matron/sister like this one.....

4. Get to grips with the history of all your patients - when you are doing the ward round with the consultant and they say "oh, who was he again?" in reference to a patient you should be able to tell them everything they need to know. If you can do that then the senior doctors and all the nursing staff will have much more confidence in what you say. How can you do that? That leads me onto.... 5. Make a patient list that you regularly update and contains the salient things you need to know - I typically make my list at the end of the day and update it very briefly with any new overnight patients the next morning. My list contains patient name, dob, hospital number, comorbidities, presentation and current management, salient blood tests or scan results and an empty box for note making. Read over this list before you start your ward round just to refresh your brain and go wow them with your knowledge!

6. Blood tests should be checked religiously and don't forget to book then in advance - most hospitals have a phlebotomy service, do take advantage of them. Book blood tests you want the day before and on Friday for the weekend (let the on call doctors know to check the blood tests during the weekend) and for Monday. When a patient has had blood taken you will typically get results back by around lunch time. Try and specifically allocate yourself a time to review blood tests and don't leave it to the last minute of the day....discovering a potassium of 7 several hours after the fact is not good practice and will leave you staining your pants at the end of the day...

8. If you have a portfolio that you need signatures for to show you have competency in skills....Get it filled early. Do not ever wait till the last minute because you will be stressed and may not even get exposure to things you need to get signed off last minute. 9. After work, chill out. Relax. Don't stress about the day. It's someone else's problem now. I strongly recommended going to the gym or doing some sport to keep you fit and get rid of work stress. But do whatever you find helps.

10. Plan out your career as far as you can. If you want to be a surgeon. Let your team know and ask to help on procedures and get in on research papers and audits. These things are easier to do the earlier you start them! And finally, have fun. Get to know your team. Have some banter. Crack some jokes. Make lifelong friends. You will have a great year. Till next time dear readers. DoctorPhantom

[doctorphantom]

As a doctor and a humanitarian I feel it is important to cover this conflict on this blog. I think this video made by a large group of Jews who want to shed light on the subject does this succinctly and reminds us that this isn't Muslims vs Jews but odious politics forming a black hole in the Middle East that must be purged. The above video is just the facts and the only opinion you will see is the following: This loss of life is beyond barbaric.

[radiopaedia]

BE HONEST - did you spot it before looking at the answer? No spoilers in comments please!

ANSWER: http://goo.gl/J9Nv8i

[doctorphantom]

This is an excellent xray for teaching! I didn't get it at first to he honest but it just goes to show that you need to look at everythingggg when reviewing an xray. 1st year med school students should even be able to pick this up but I get even radiologists would miss this. Lol

[doctorphantom]

That Moment When the Senior Grade Doctors are Busy/Away and the Middle Grade is in Charge

Am I right? lol

[doctorphantom]

The United Kingdom Has the Best Healthcare System out of the Top 11 Richest Countries........USA is the 11th......

Surprising? Hardly. Despite the much larger healthcare "industry" in the USA the UK has much better health outcomes. The major reason behind this according to the researchers? Free healthcare for all.......as if anyone didn't see this coming from a mile away.

America, your healthcare system is a disservice to your people, an outright betrayal. If treason is to go against your country then the government is committing high treason against you all.

In the UK, where I work for the National Health Service as a doctor, whatever the emergency - you will get an ambulance to the hospital (helicopter, car or boat), seen by a triage nurse and then a doctor as soon as possible, referred to the relevant specialist on the same day, have blood tests, scans and food provided, stay in hospital until everything is sorted (having blood tests, physiotherapy, dietician input, social workers, occupational therapists, nursing care, medications, equipment) and when you are discharged the specialist consultant will instruct a community doctor (GP), that acts as your main doctor, on any follow up plans. All medications you may require are heavily subsidised or free. All this is paid for through taxes. Not once do you have to worry about insurance premiums and whether you can afford to get checked up. Amazing.

Sure there are problems with the NHS - waiting times can get a bit long and we don't have the absolute cutting edge drugs (most of which have negligible benefit over older drugs anyway) and the staff are underpaid and over worked (these are all issues with government underfunding basically, not the fundamental idea of the NHS) but despite all that I am proud of the achievement of the National Health Service here.

And then on the other hand we have the USA, a country where the healthcare system itself inhibits patients from even presenting to a doctor - there is something majorly wrong going on when people are afraid to even go and see a doctor. You can have the best healthcare system in the world but if you don't have a patient in front of you, what can you do?

Here's a thought - If Walter White, of Breaking Bad, was a UK citizen........Breaking Bad would have ended on the 2nd episode with Walter getting his treatment for free.

As someone from the outside looking in - sort your government out people of America. They are unworthy of you.

(research by the commonwealth fund)

[doctorphantom]

Hi! I was wondering what you intend to specialise in/specialising in? Btw it's really nice that I found your blod! I'm a pre-med from Australia and I'm new to the whole Medblr community but I hope to be more involved in it, so hello! :D

Welcome to the medblr community! I'm relatively new to it too to be honest. Just hit my first year anniversary in fact!

I myself wish to specialise in plastic surgery....or maybe trauma and orthopaedics. I'm not 100% sure just yet. But they share a lot of common training so I have time to decide.

[comedycentral]

[doctorphantom]

you know how they say prevention is the best form of medicine....well........

[doctorphantom]

A doctor... minus the mask. turned 1 today! Tumblr tells me it's my first birthday! yay!!!

[wayfaringmd]

Good day, doctor! I'm in my 3rd yr of medschool from the Philippines. It's mentioned quite often by our facilitators the problem about the big number of doctors leaving the country to work abroad (for long term and not just for training). I'm really curious how the people from the 'other side', so to speak, perceive that? Knowing that there is a scarcity of doctors all over moreso in the Third World countries. Thank you for your time.

Pretty much the entire world has a doctor shortage right now. The US and most countries welcome qualified docs from other countries so that they can help relieve some of this shortage. Of course, many patients, especially in my neck of the woods, are prejudiced against doctors with accents or skin that is shaded differently from their own. But many of them also learn that these doctors are smart and capable and are willing to help them, so they usually swallow their pride pretty quickly ;).  

As a country that treats capitalism like a command handed down from God, we totally understand when docs want to come here from their home countries when they have the potential to make more money and live more comfortably here. Many doctors don’t understand why some of us would willingly go to work in rural or underserved areas or to work abroad in a volunteer or nearly-free capacity when we have the option to make the big bucks and live comfy lives in the city. 

I’m in the opposite position from you, ropheka. I’m a US doc looking to potentially move overseas to do medicine. Some would see that as hypocritical and argue “why go over there when there is so much need here?” My argument is and always has been, “what are the people who are called to stay here doing to relieve the shortage?”

Are the docs who complain about millions of uninsured patients starting or volunteering at free clinics to help them? Are they expanding the percentage of medicaid and medicare and self-pay patients they see? Are they lobbying in their state and national legislatures to create more primary care residency slots or to expand medical coverage for the poor? Are they involved in educating future doctors and encouraging them to work in rural or underserved areas? These are things I’ve been committed to during my time in the US, even as a med student and resident. 

Ahem, let me step down from my soapbox. This post has turned into an entirely different beast than what I think you intended, ropheka. 

[doctorphantom]

Good post.

In the UK there isn't a doctor shortage, rather the government just won't hire enough doctors to safely treat patients. We are understaffed to within an inch. In fact if you look at major disaster protocols most hospitals in the UK would fail and directly cause loss of life due to being undermanned.

Such a shame that our noble profession must be muddied by the green stained fingers of capitalists and politicians.

[doctorphantom]

The Most Interesting Abbreviated Memory Test I Have Ever Done

*for best effect, imagine my voice as that of a modern Briton and imagine the patient's voice as that of an old lady from Downtown Abbey*

Doctorphantom: Hello! I'm Doctorphantom, one of the doctors on the ward today. I just wanted to do a quick memory test on you if you don't mind, just to compare with the memory test we did on you when you first came to us. Is that all right?

Patient: Ohhhhh! Hellooooo! So you're a doctor? Myyyy aren't you young! Doctors are getting younger and younger! Handsome too!

DP: Haha. Thanks dear. Let's start the test shall we, I just need to -

Patient: Ohhh already? But I don't have a pen. Can I borrow yours young man?

DP: Oh don't worry, you don't need one.

Patient: Oh good

DP: You just need to answer my questions. Shall I start?

Patient: Yes, yes, go ahead.

*patient procedes to answer her age and DOB correctly*

DP: OK, what year is it?

Patient: Ohhhh, ahhhh, two million and...........fourteen.

DP: Two million? You told me you were born in 19xx though and you were in your 90s. You aren't nearly 2 million years old now are you? Haha.

Patient: Ohhhh, I had no idea I was 2 million years old! I need more candles on my cake doctor!!

DP: No, no! You were right the first time, dear! You ARE in your 90s. It is the year two thousand and fourteen.

Patient: Oh I SEE!

DP: OK, do you know which hospital you are in?

Patient: Yes, you're hospital.

DP: But what is it called? Or what is this area called?

Patient: Hmmmmm it must be called doctorphantom's hospital I'm guessing?

DP: I wish! But no, you are in X hospital.

Patient: Oh bother! I knew that. I just couldn't quite remember.

DP: Don't worry! Let's move onto the next question. Do you know what time it is right now, roughly?

Patient: I bet you know what I'm going to say....

DP: What's that?

Patient: About time you got a watch!

DP: Hahaha, but really though, what time or time of day do you think it is?

Patient: Oh, I guess it's around one O'clock because I had that dreadful hospital lunch not too long ago.

DP: Yeah that's right.

Patient: Oh so you've tasted hospital food too? I just can't stomach it!

DP: Hahaha, I was referring to you telling me the correct time! OK, when was the end of world war 2?

Patient: Oh, I remember that well. *patient begins telling me a long tale*

DP: *finally finds a point to interject at whilst not seeming rude* - ah, so what year was that when you heard the last bomb go off?

Patient: Hmmmmm, I can't seem to remember actually! Ask me again another time.

DP: "omg, I listened to all that for nothing >_>" OK, who is sitting on the throne?

Patient: Oh, her Majesty, Queen Elizabeth!

DP: Correct

Patient: It should really be me though *said in a genuinely disappointed voice*

DP: Hahaha. OK just a few more questions:

*I continue to ask the rest of the AMT questions: counting down from 20 to 1, recalling an address, recognising my job*

DP: OK! All done. You didn't do too bad at all, an improvement from when we first saw you actually.

Patient: Oh good! I passed! Will you give me a memory certificate now?

DP: Haha, not exactly, but it's important for us to know that your memory has returned to it's baseline.

Patient: Can you give me a certificate anyway? That WAS a hard test after all!

DP: Haha, I'll see what I can do. It was lovely to see you, dear. Take care

Patient: Oh you too young man! Do visit!

*I come back later with a powerpoint certificate I cobbled together*

Patient: Ahhhh! My certificate! I am going to put this right next to my hard of hearing sign on top of my bed! Thanks love!

DP: Hahaha! Not a problem! Have a nice day!

[cranquis]

TSK: Coinky-dinks?

Scene I: Cranquis and Colleague at workstation

Colleague: This little boy I saw today — you saw him last year when he had a rash and fever, and you thought it was early chickepox or another viral rash. Did you know it later turned out to be Serum Sickness-Like Reaction from amoxicillin?

Cranquis: What? Man, I don’t even remember what that condition presents like.

Colleague: I didn’t either! Here’s an UptoDate article on it.

Cranquis: Thanks. (reads article) Oh man, that kid DID have all these symptoms. I totally missed the SSLR diagnosis!

Colleague: Don’t feel bad, I would’ve missed it too.

Scene II: 4 hours later, Cranquis in a different patient’s exam room 

Patient: So I woke up with a painful bumpy rash over my joints this morning and felt feverish, and my knees hurt.

Cranquis: 

Read More

[doctorphantom]

Haha, a proper "house" moment for cranquis xD.

Love it when stuff like this happens. Had a similar feeling when I diagnosed someone with booerhaaves earlier in the year.

[doctorphantom]

Really you are! All FIVE HUNDRED + of you! (wooooo, new milestone!)

I must say I am truly humbled to have your attention, even if fleetingly, when I post and even more humbled when you think my posts worthy for a reblog. It really encourages me to post even if I am knackered from work, haha!

Hope to keep posting and, like always, I'm always glad to answer questions and am open to suggestions.

Till next time dear Reader,

Doctor Phantom

[doctorphantom]

The real reason babies cry.........that remnant of higher knowledge before being engulfed by fast toy cars, cheap barbies and milk. You tiny giants, I salute you!

(p.s. do hospital still have these huge rooms full of babies? I have never seen one in my career so far)

[comic by gunshow]

[doctorphantom]

RIP Ultimate Warrior.

My childhood would have been a lot less crazier without you =[

[doctorphantom]

The above is me during the end of shift handover. You know it has been a rough 13 hour day when your calcaneal tendon is inflamed, your contacts are burning your eyes since they are so dry from you not having drunk any water, your stomach feels like it is on a simmer from not having eaten anything and the pedometer on your phone reads that you walked nearly 20 kilometres during the day.......

I. AM. EXHAUSTED!

On the other side, saved quite a few lives today through perseverance. Some lives that we thought were more likely going to die than pull through. Always a nice feeling.

Now to sleep and do the same thing tomorrow.....